血管紧张素转换酶抑制剂对硝酸甘油抗血小板聚集作用的影响

Influence of Angiotensin converting Enzyme Inhibitors on the Inhibition of Platelet Aggregation by Nitroglycerin

目的：观察硝酸甘油静脉滴注过程中血管紧张素转换酶抑制剂对血小板聚集的影响。方法：将６２例急性心肌梗死和不稳定性心绞痛患者分为硝酸甘油组、硝酸甘油＋卡托普利组、硝酸甘油＋非巯基血管紧张素转换酶抑制剂组。观察临床情况、血小板聚集、血小板环磷酸鸟苷、血浆６－酮－前列腺素Ｆ１α、血管紧张素Ⅱ。结果：加用血管紧张素转换酶抑制剂的两组血小板聚集的抑制程度较硝酸甘油组明显（Ｐ＜０．０５），临床情况改善也较硝酸甘油组明显。血管紧张素转换酶抑制剂加强硝酸甘油抗血小板聚集作用主要与血小板环磷酸鸟苷和血浆６－酮－前列腺素Ｆ１α有关。结论：卡托普利和不含巯基的血管紧张素转换酶抑制剂均可加强硝酸甘油的抗血小板聚集的作用。

Objective:To investigate the influence of angiotensin converting enzyme inhibitors (ACEI) on platelet aggregation during nitroglycerin (NTG) infusion. Methods:Sixty two cases of acute myocardial infarction and unstable angina pectoris were divided into NTG,NTG plus captopril,NTG plus non sulfhydryl ACEI groups.Clinical manifestation,platelet aggregation,platelet cyclic guanosine monophosphate(cGMP),plasma 6 keto PGF 1α ,angiotensin Ⅱ (AngⅡ) were investigated. Results:The inhibition of platelet aggregation in NTG plus captopril group and NTG plus non sulfhydryl ACEI group was more enhanced than that in NTG group ( p <0 05).The improvement of clinical manifestation in the former two groups was more apparent than that in NTG group.The enhancement of the inhibition of platelet aggregation by ACEI was mainly associated with platelet cGMP and plasma 6 keto PGF 1α . Conclusion:Both captopril and non sulfhydryl ACEI can enhance the inhibitory effection of NTG on platelet aggregation.